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Neuro-ophthalmic Manifestations of Wernicke Encephalopathy

Authors Isen DR, Kline LB

Received 1 May 2020

Accepted for publication 9 June 2020

Published 30 June 2020 Volume 2020:12 Pages 49—60


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Margaret Wong-Riley

Danielle R Isen, 1 Lanning B Kline 2

1Department of Neurology, University of South Alabama School of Medicine, Mobile, AL, USA; 2Department of Ophthalmology, University of Alabama School of Medicine, Birmingham, AL, USA

Correspondence: Lanning B Kline
Department of Ophthalmology, University of Alabama School of Medicine, 700 South 18th Street, Suite 601, Birmingham, AL 35233, USA
Tel +1 205 488 0756

Abstract: Wernicke encephalopathy (WE) is a life-threatening but reversible syndrome resulting from acute thiamine deficiency that is frequently overlooked and underdiagnosed. It is classically characterized by a triad of ocular dysfunction, ataxia, and altered mental status. However, less than 1/3 patients have the complete triad, so it is crucial to have a high index of suspicion. Awareness of the early signs of WE is essential to prevent clinical progression, as patients with the full triad already have a profoundly thiamine-deficient state. This review highlights the neuro-ophthalmic manifestations of WE to guide the clinician in identifying the condition. In addition, we provide an update regarding the clinical characteristics, pathophysiology, neuroimaging and laboratory findings, treatment options, and prognosis of WE.

Keywords: Wernicke-Korsakoff Syndrome, thiamine deficiency, ocular findings, review

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